When to ask for help

As a therapist and coach, one of the many questions I get asked is, "How do you know when it's time to ask for help?" I totally get why people ask this. It can be difficult to figure out when to say "when", especially if you're a high-functioning person like most of my clients are. In honor of Mental Health Awareness Month, here are three major signs you could benefit from some outside help:

1. When you aren't functioning well

This can mean something different for everyone, but one of the most telltale ways to notice is through your body. When we're not functioning well we can have all sorts of physical symptoms, like sleeping too much or too little, stomach problems, skin problems, racing heart rate, panic attacks, eating too much or too little, aches and pains that seem to come out of nowhere, and other physical issues. Things may look great on the outside - you're killing it at work, you're finishing all your creative projects, and you're spending time with family and friends - but maybe you're rushing to the bathroom several times a day or you're tossing and turning all night with your mind running a million miles a minute. This is a sign you aren't functioning well and might need to seek out some help.

2. When someone close to you says something

You might also ask for help when someone close to you starts noticing you're not functioning well. Maybe you're dropping the ball at work or at home. Maybe you're more irritable or spacey than usual. Maybe you're drinking too much. Loved ones can offer us an outside perspective we might not be seeing. When someone else points this stuff out, it can be difficult to accept, but if it comes from someone you trust, who you know has a good head on their shoulders, I encourage you to give it some serious thought.

3. When you feel stuck

Sometimes we just can't get out of crappy feelings or we can't seem to move forward. A lot of my clients come to me with this type of feeling. They say things like, "I'm anxious all the time and I'm tired of it.", "I'm ready to take my creative work to the next level, but I'm terrible at self-discipline.", or "My partner and I keep having the same fight over and over again." Being stuck is the most common reason people come to therapy or coaching. If you feel like you've been stuck for awhile, it might be time to seek out some help.

Help can come in many forms

It doesn't always have to be structured or professional. It can be a long conversation with a trusted friend or mentor, a request of your partner to listen more, a support or accountability group, or - of course - a therapy or coaching session. If you're looking to find a great therapist, I encourage you to take a look at my handy guide on the subject. It contains links to directories, tips on what to ask during your consultation, and advice for getting the most for your time and money.

No matter who you are, it's ok to ask for help. Your love and care for others - and your creativity - are only enhanced when you take the time to care for yourself. 

Is your relationship cheat-proof?

Let me answer that for you: No, it isn't. There’s no monogamous relationship that’s 100% guaranteed safe from an affair. Sometimes feelings develop for other people. It's only natural. But it can be a signal that something is missing from your relationship or your life.

So, what do you do if you or your partner gets feelings for someone else? This answer is often the key to whether or not your relationship survives an affair or even a potential affair. We need a sense of safety in a relationship in order to thrive. With that safety comes honesty, trust, and respect. When we have feelings for someone else we immediately have a choice: Tell our partners or don't. What matters is how safe it feels to talk with our partners. 

How would you react if your partner told you they had feelings for someone else? Would you get angry? Would you break up with them? Would you forbid them from leaving the house? Or would you listen and acknowledge their feelings? Would you be honest about your feelings? Would you ask your partner if there's anything you can do to help your relationship? Would you discuss polyamory? Or suggest couples counseling?

There are so many possible outcomes when feelings arise for someone else. What we need to understand, however, is that only we are responsible for our actions. If you've made a clear, monogamous commitment to someone, I encourage you to stop before you act on any romantic feelings for someone else. "One thing led to another," is a lot harder to hear than, "I think I have feelings for someone else and I don't know what to do."

What are your experiences with infidelity?

Have you developed feelings for someone else while in a monogamous relationship? What did you do?

Have you ever been cheated on? Did you work it out? What do you wish your partner would have done?

Leave a comment below and tell me what happened.

Is that how you REALLY feel?

When it comes to couples, a lot of people talk about "communication". Often we hear "A good relationship is all about communication" from advice givers or "We just didn't communicate" from recently broken hearts. Here's the thing: it's not that you communicate - because we all do, even when we're not speaking - it's how you communicate.

In love relationships, communication gets complicated. Because we've fallen intimately in love with someone, and they with us, we often expect them to know exactly what we need at all times. Why is it that we expect so much? I'm not completely sure why. Much of it has to do with attachment style, which dictates how we interact with others, but the rest seems to defy logic. Many times, we ask our partners to be superhumans - to behave in ways that are only agreeable to us and our wants and needs. If they don't, we get angry or upset and many times our partners have no idea why. Then they react, usually by either fighting back, going silent, or defending themselves in some other way. That's an all-too-familiar pattern that often brings couples to therapy.

Let's look at it a little closer with an example. I'll use wife and husband here to avoid confusion, but this could be any iteration of a love relationship: wife and wife, boyfriend and girlfriend, husband and husband, etc.

A husband is patiently waiting for his wife to get home from work. He knows she gets home around 5:30. She has had a particularly stressful week, so he decides to make her a surprise dinner which will be ready right when she gets home. 5:30 rolls around... no wife. 5:45, he calls her cell and she doesn't answer. 6:00 and now he's really worried, pacing the floor, wondering if she got into an accident or worse. He calls several times and goes through all the horrible scenarios in his head, getting very anxious and concerned. At 6:30, his wife walks in the door looking perfectly fine. Before she can speak, her husband goes off, yelling about how inconsiderate she is, how the dinner is ruined, and how much she clearly does not care about him or his time. Instead of telling her husband about the long promotion conversation she had with her boss in the lobby and how her cell phone was dead, the wife says something like "You're being ridiculous! How was I supposed to know? You NEVER cook. I'm sure it was awful, anyway." and storms upstairs to the bedroom. Both partners are now pissed at each other over what is essentially "being late for dinner".

So, are these people communicating? They sure are, but they're communicating what Sue Johnson, one of the founders of emotionally focused therapy calls "secondary emotions".  These are the defensive emotions that come out of what is expected from your partner, but not the ones that started the process in the first place. In our example, the husband was scared about what could have happened to his wife and then hurt that she was fine, but did not tell him she would be late. The wife was then hurt that she was yelled at and accused of not loving her husband as soon as she walked in the door. She was probably also quite disappointed that she could not share her exciting news with her husband.  If this couple had communicated their primary emotions, they might have avoided an argument or could have at least had a more productive one. If the husband said something like "I'm so relieved to see you! I was so worried. Why didn't you call?" The wife likely would likely have immediately apologized and then shared her story.

I'm willing to bet this sounds familiar to you. I've done it and still do, although I tend to catch myself a lot more often nowadays. It's a hard cycle to break and we're human: sometimes we just go off without thinking about it. Here's a tip on how to become a bit more self-aware: when you're angry or upset with your partner, think about the situation - the interactional cycle - that caused you to feel this way. Are you hurt by something she said? Are you afraid he will leave you because of something he did? Do you feel lonely or unwanted? If so, try communicating that emotion instead of yelling, crying, or shutting your partner out. Or try to consider the situation for a moment: are you expecting your partner to read your mind? For example, are you upset because she is behaving in a way that she should know would hurt your feelings, even though she's trying to do something good? As I've said before, S L O W  D O W N, think before you react, and ask for what you REALLY need. State how you REALLY feel, before all those fight or flight mechanisms stepped in. If that's too much for you, take a step back, check the defensiveness rising in you, and see how you might soften your reaction. You may even determine that the anger is completely unnecessary and happily go on with your day! (Seriously, it's happened to me before). Now, this is not to say that anger or sadness are inappropriate emotions, but you'll be surprised at how productive a conversation can be when it starts out with a certain softness, with a statement of personal need or desire, instead of blaming, nagging, or walking away.

Five ways to get your money's worth from your therapist

I know, therapy is expensive. Like I said: it's helpful to think of it as an investment. You're investing in your self or your relationship or your family. You're giving your life a tune-up. It all costs money. You're putting yourself in the hands of a professional in order to do so. Someone who has been educated and trained for, at the very least, 5 years if he or she is licensed. This person should know their stuff and that can be intimidating. BUT, it doesn't mean your therapist should be telling you what to do and it doesn't mean you can't trust your gut. In fact, your counselor should be encouraging you to trust and depend upon yourself. Here's a short  list of advice on getting your money's worth from therapy:

1. Ask questions, debate points, and give feedback Ask for what you need. If you don't understand something your therapist says, ask. If you disagree with something she says, say so. This doesn't mean you shouldn't listen to her, but when something feels inherently wrong, just way off from who you are, SAY SOMETHING. It doesn't help you at all to stay mute on the subjects that really rile you up. Again, your therapist is not your friend; she is providing you with a service. Having said that, however you must understand that you also have to...

2. Do your homework Many therapists gives little assignments to their clients. You might be asked to journal something or to complete a questionnaire online or to notice a behavior or thought process during the week. Try your best to do these assignments. They are given to you for a reason and completing them shows your therapist how committed you are to working on yourself or your relationship. If you don't complete your homework, let your therapist know why. Perhaps something needs to be changed about it or perhaps it's telling you something about yourself or your counselor.

3. Listen Listen to what your therapist has to say, the questions he asks, and the insights he might have. He may have some very valuable points to make or inquires. However, your counselor should not be doing most of the talking. If this is the case, speak up. You're there to talk about your life, not listen to your therapist drone on because...

4. You're the expert I know this sounds strange, but you are the expert on your own life and relationships. A good therapist should never act as if she knows what's best for you. A good therapist does not give advice. I repeat:A good therapist does not give advice. A good therapist asks good questions, gives good insight and good suggestions. The point of therapy is to give you (or you and your partner or you and your family) the ability to make the right decisions for yourself, not to make you dependent on your therapist.

5. Work through the discomfort Part of any therapy, whether it be individual, couple, or family, is building self-awareness. With this comes the uncomfortableness of dealing with emotions you'd just rather not feel. Things like sadness, anger, guilt, and hurt. Things that make you feel vulnerable. I can say this from my own experience with therapy: Lean into the discomfort. Because when you come out the other side you've learned more about yourself, more about how you affect others, more about what works for you and what doesn't, and more about the joy you can have. Be gentle with yourself, though. Handle what you can at the times you can. Take it slowly.

I know we hear this all the time, but it is a worthy adage: Take risks. It's the best thing you can do for your brain and for your heart. You've taken the risk to go seek help, now take the risk to make the most of it.

Congratulations, you've found your therapist! Now what?

It's the 1st session. You're nervous, asking yourself questions like "What will she be like? Will he think we're crazy? What have I gotten myself into?" If you've never been to a therapist before, it's like walking into a small room with a stranger who has agreed to take your money to provide you with a product you know little about. It can be weird and feel awkward. You're taking a big risk entrusting someone else with your problems, with your life. And kudos to you for your courage! I want to try to make it all a little less daunting, so here's a brief guide of what to expect when you walk into a therapist's office for the first time:

When you get there, you will be greeted with the usual pleasantries and a bit of small talk, but eventually you'll have to get serious. Your therapist will soon ask "what brings you here today?" You may have talked about it on the phone prior to your appointment, but some version of this question will be posed to bring the focus to exactly why you're paying to be there. Attempt to be as honest as you comfortably can be. It's natural to feel strange about telling someone you've never met your most hurtful problems. You don't have to say everything, just try to be truthful. This can be extremely difficult when you've come to therapy with a spouse and it's the therapist's responsibility to help you feel as safe as possible in his or her space. This is YOUR time. Use it wisely.

When you come to therapy for the first time, at some point in the session you will be asked to sign confidentiality agreements and other documents. Your therapist should verbally describe the important points of the documents to you. If you do not understand certain parts of the document, be sure to ask. Again, this is for you, not the therapist. Good questions to ask include:

• Does anyone else have access to your files?
• What do I do in an emergency?
• Who will take over for you when you go on vacation or if something were to happen to you?
• Will I/we have a diagnosis?
• Can I/we give feedback?
• What theories do you use? - I, for example, am quite interested in emotionally-focused therapy. Common approaches are cognitive-behavioral, solution-focused, and systems theory (for couples or families).
• What sort of education or experience do you have with my/our specific problem(s)?

The therapist may also administer certain assessments or tests, depending on what your complaint is.

If you're going with your spouse or partner, it is also important to ask who the client is. Is it the person who called or is it the couple as a whole? You might also want to ask about confidentiality if you have individual sessions. Will the therapist keep secrets or is everything out the open, no matter what? My advice here, don't put your therapist in the position of keeping secrets from your spouse. You're in therapy - be honest. This is probably the one place in your life where you won't be judged for what you do, within reason.

NOTE: a therapist MUST report to the authorities if a person presents a reasonable threat to him/herself or others or if child or elder abuse is evident. There is also no statute of limitations on sexual abuse, so a therapist must report a living offender even if the abuse occurred many years ago. This should be discussed in your first session, as well. The therapist does not have a duty to report domestic abuse and may or may not be willing to work with abusive couples. This should be established before you get to your first session, though.

A really good therapist will have you feeling safe and heard within the first one to two sessions. If after the second session, you are not feeling this way, speak up! I hear stories all the time about people sticking with a therapist who they feel "did me no good" for long periods of time or who "liked my partner better than me". My first response is always: "Did you say anything?" or "Why did you keep going??" Again, it's weird - you're telling this person so much about your life. It's SO personal. Keep this in mind, though: your therapist is not your friend. You are paying this person to provide you with a service. You have the right to complain or seek help elsewhere (you can even ask your therapist for a referral) if you don't feel like your needs are being met. Do this, and you will get the most you can out of the therapeutic process.

Have any other great advice for therapy newbies? Let it loose in the comments section!

Next week: More on getting your money's worth in therapy